Beginning the Scanning Process

Yesterday we began the after treatment scans. These scans will let us know if all the treatment have stopped her tumor from growing and contained it to the area right below her kidneys.

The first one on the list was the bone marrow biopsy. Jesse and I arrived at clinic at 7:35am. I wanted to get there early to get Jesse on the list for the anesthesiologists.  The way it works is bone marrow biopsies are fitted into the schedule of the anesthesiologists, who’s schedule is made months in advance.  This means if they have a crazy schedule, Jesse won’t have the procedure done until 2 or 3pm. This also means she can’t eat until after she wakes up.

I am very proud of how patient she was. She only asked once if she could eat, but when I explained we couldn’t till after they took her bone marrow, she never asked again.

At first when I mentioned the anesthesiologist, she asked if she was getting her picture taken (this is what we called radiation). I explained that no, this would be different.

At 10:30am, our nurse asked Jesse to come with her to the procedure room. I tagged along. I planned to stay until she fell asleep, but when our doctor didn’t seem to mind I was there, I just stayed.  This might sound horrible, but I have been curious as to how bone marrow biopsy is done.

In the room was a lab technician with 10 lab trays set out. One set for the left hip, one set for the right hip. Since Jesse is on a study, they take two samples.

Then our nurse attached Jesse to Fred the IV Pole. We talked about Fred taking sleepy medicine, and would she help Fred take a nap.  The anesthesiologist gave her ketamine. He gave her a small dose at first with the intention to finish the rest after a few minutes. We had to stop Jesse because she figured she help by pushing in the rest.

When he pushed in the rest, she was out.  While she was going to sleep, our doctor was getting sterile. He asked her if the blue sterile gown met her approval. This is a throw back to Jesse telling him he had on the wrong color one day.

When she was asleep, they rolled her on her side. First they swabbed the area with sterile scrubs (I can’t remember what it’s called), then he stuck a needle of lanicane on each side. Even in her sleep Jesse did jerk a little. In fact our nurse was positioned to hold her in anticipation of this. After doing tape changes, I totally understand the need to hold her down. And I would rather they hold her down than have her jerk causing more painful damage.

The doctor noticed I was watching intensely. He was surprised when I said this was the first one I had seen. When I explained that the other doctor wasn’t comfortable with me being in the room, he understood. And they talked about a poor lab technician who fainted when he saw his first bone marrow biopsy. Unfortunately the lab technician hit the bed when he passed out breaking his jaw.

After the injections, he took out a needle with a blue cap from a sterile kit. This was shoved into her hip, the blue end opened, and a syringe used to draw out blood from that area to test. The technician then put drops on each slide and used another slide to flatten out the sample.

The doctor replaced the blue cap and removed the needle.

Then he retrieved a larger needle from the sterile kit.  Here is a picture:

This picture is from kendallhq.com

This needle was shoved into her hip. This didn’t look easy, and as the doctor explained, you don’t always get bone marrow. And even though Jesse was asleep, she would still try to arch her body away. When she did this the anesthesiologist would give her more ketamine. She ended up getting 50mls of ketamine through her CVL.

Getting bone marrow is like augerring a tree for a sample. We were lucky and got a sample on the first try.

Pulling this needle out was not easy. In fact Jesse’s skin would rise with the needle as it came out. The doctor would push it down to prevent a tear from happening.

When this hip was completed, a new needle was used on the other hip. The sample was taken in the same way, and the technician carefully labeled everything for the lab.

Jesse was wheeled to another room to recover, which didn’t take her long. She began fighting the ketamine within a half hour. By 12:45pm, we were out the door and on our way back to Williamsburg.

By that afternoon, Jesse was running around playing. She did act a little stiff, but it didn’t really seem to slow her down. She was by herself most of the afternoon because her sister went hunting with her dad for the first time. I am really surprised that Chris was quiet and seemed to really enjoy the experience.

This morning, Jesse has had several grumpy episodes. I am sure she is sore, but when I ask her if anything hurts she says no. She did tell her dad last night that the doctor took her “bone mares and I have band-aids on my butt!” She is very proud of her band-aids, as she should be 🙂